Comparison of Surgical Techniques Used in Adult Varicocele

Background: A varicocele is an abnormal dilatation of veins in the pampiniform plexus of the spermatic cord. Several methods have been used for its treatment including open surgical ligation of the spermatic vein as well as laparoscopic and microsurgical varicocelectomy. Objective: To compare laparoscopic varicocelectomy with open varicocelectomy techniques in patients of varicocele in terms of operative time, duration of hospital stay, recurrence rate and effect on semen parameters. Methodology: th Study Design: Randomized clinical trial Setting: Punjab Medical College and affiliated hospitals. Duration: 27 September 2014 th to 26 September 2016. A total of 129 patients of varicocele were included in the study. All patients were diagnosed clinically as having varicocele. 43 patients underwent laparoscopic varicocelectomy (group A), 43 open varicocelectomy using retroperitoneal approach (group B) and 43 underwent open inguinal approach(group C). Outcome in terms of operative time, duration of hospital stay, recurrence rate and impact on semen parameters, was compared in three groups. The data was entered and analyzed by using SPSS version 20. Results The operative time and hospital stay in the laparoscopic group were significantly shorter than in retroperitoneal and inguinal groups (P < 0.01). Recurrence rate was 18.6% in the open inguinal group, 16.27% in the retroperitoneal group, and 4.65% in the laparoscopic group. This lower rate of recurrence was statistically significant in the laparoscopic group (P < 0.05). Among the three groups, comparisons between preoperative and postoperative semen parameters revealed improvements in sperm concentration and motility (P < 0.01). Conclusion: Outcome of laparoscopic varicocelectomy is better than open varicocelectomy techniques in patients of varicocele.